Short-Term Clinical Outcomes of Implantation of Aspheric Diffractive IOL after Vitrectomy for Macular Epiretinal Membrane

Abstract

 

Purpose

 

To evaluate visual functions after implantation of aspheric multifocal intraocular lens in vitrectomized eyes for epiretinal membrane

 

Methods

 

This was single-center consecutive case series by retrospective chart review of patients who had received phacoemulsification and implantation of intraocular lens after vitrectomy (by one operator) for idiopathic epiretinal membrane (ERM). We compared visual function between implantation of multifocal IOL (ReSTOR®) and monofocal IOL. The main outcome measures were uncorrected and corrected near, intermediate and distant visual acuity, refractive errors, contrast sensitivity, subjective visual symptoms and satisfaction using modified VF-7 at postoperative 1 day, 1 week, 1 month, 3months.

 

Results

 

At the 3-month postoperative visit, the mean uncorrected near, intermediate and distant visual acuities of multifocal IOL and monofocal IOL were 0.23±0.08 (multifocal IOL) vs 0.46±0.08 (monofocal IOL), p=0.001 ; 0.34±0.14 vs 0.50±0.21, p=0.043 ; 0.18±0.08 vs 0.17±0.09, p=0.762, respectively. There were significant differences in uncorrected near and intermediate visual acuities. The mean of contrast sensitivity of multifocal group was lower than monofocal at 1.5, 3 cycle/degree in photopic condition. But there was no significant difference in mesopic condition. The patients reported excellent spectacle independence with good result of modified visual function 7 scores except driving at night. Two patient (18%) were dissatisfied with the operation, who had a pseudolamellar hole pattern in OCT before vitrectomy for ERM.

 

Conclusions

 

The multifocal IOL provided significantly better uncorrected near, intermediate visual acuities, and modified VF-7 leading to less need for spectacles to patients who have already done with vitrectomy for ERM than monofocal IOL. But, contrast sensitivity in multifocal implantation was lower than that in monofocal IOL & even much worse previous studies with simple cataract cases. Consequently, in case of mild & not on-going retinal disease such as ERM, it is possible to implant multifocal IOL in vitrectomized eyes with great sensitivity & care.

 

 

Fig1. Comparison of contrast sensitivity at photopic (Left) & mesopic (Right) condition in Monofocal Vs. Multifocal IOL

 

 

Fig2. (Upper) Changes in satisfaction using modified VF-7after 3 months of multifocal IOL, (Lower) Epiretinal membrane patterns with the morphology of OCT

 

Keywords: 688 retina • 585 macula/fovea • 760 visual search